Construction and validation of a traditional Chinese medicine clinical prediction model for polycystic ovary syndrome with metabolic syndrome

PAN Zimeng; HOU Lihui; SUN Miao; YU Jinglu

doi:10.16305/j.1007-1334.2025.z20250124004

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Construction and validation of a traditional Chinese medicine clinical prediction model for polycystic ovary syndrome with metabolic syndrome

更新时间：2025-07-31

- Construction and validation of a traditional Chinese medicine clinical prediction model for polycystic ovary syndrome with metabolic syndrome
- Shanghai Journal of Traditional Chinese Medicine Vol. 59, Issue 8, Pages: 72-78(2025)
- 作者机构：
  
  1.北京中医医院顺义医院妇产科（北京 101300）
  2.黑龙江中医药大学附属第一医院妇科二科（黑龙江哈尔滨 150040）
  3.黑龙江中医药大学附属第一医院产科（黑龙江哈尔滨 150040）
- 作者简介：
- 基金信息：
- DOI：10.16305/j.1007-1334.2025.z20250124004
  CLC：
- Received：24 January 2025，
  
  Published：10 August 2025
- 稿件说明：
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潘紫萌,侯丽辉,孙淼,等.多囊卵巢综合征伴代谢综合征中医临床预测模型的构建和验证[J].上海中医药杂志,2025,59(8):72-78.

PAN Zimeng,HOU Lihui,SUN Miao,et al.Construction and validation of a traditional Chinese medicine clinical prediction model for polycystic ovary syndrome with metabolic syndrome[J].Shanghai Journal of Traditional Chinese Medicine,2025,59(8):72-78.
潘紫萌,侯丽辉,孙淼,等.多囊卵巢综合征伴代谢综合征中医临床预测模型的构建和验证[J].上海中医药杂志,2025,59(8):72-78. DOI： 10.16305/j.1007-1334.2025.z20250124004.

PAN Zimeng,HOU Lihui,SUN Miao,et al.Construction and validation of a traditional Chinese medicine clinical prediction model for polycystic ovary syndrome with metabolic syndrome[J].Shanghai Journal of Traditional Chinese Medicine,2025,59(8):72-78. DOI： 10.16305/j.1007-1334.2025.z20250124004.

摘要

目的

借助回顾性队列研究方法，建立并验证多囊卵巢综合征（PCOS）合并代谢综合征（MetS）的中医临床预测模型，助力疾病的早期预防和干预。

方法

收集PCOS患者的临床资料，根据就诊时间分为训练集、验证集，进一步将训练集和验证集患者分别分为MetS组和No MetS组，比较两组患者中医证候信息的差异；将患者的临床相关数据作为协变量，以MetS为结局变量，构建PCOS伴MetS中医临床预测模型，采用受试者操作特征（ROC）曲线和校准曲线评估模型的表现，并用Bootstrap法进行内部验证；采用ROC曲线、校准曲线、校准斜率、校准间距对模型进行外部验证。

结果

共收集1 063例PCOS患者，MetS的患病率为27.66%。利用Lasso回归筛选出潮热盗汗、形体肥胖、肾虚肝郁证、痰瘀互结证、舌苔白腻、舌淡红6个中医因素，构建预测PCOS伴MetS的中医模型，ROC曲线C-统计量为0.843［95%

（0.814～0.871）］，Youden值为0.513时，敏感度为82.3%，特异度为69.0%，校准曲线Brier得分0.139分。Bootstrap内部验证C-统计量0.838，Brier得分0.142分，外部验证ROC曲线C-统计量为0.824［95%

（0.774～0.874）］，Brier得分0.149分。

结论

痰瘀互结型PCOS患者具有较高的MetS患病风险，对PCOS的评估有显著甄别性；该中医临床预测模型可靠性高，具有良好的临床应用价值。

Abstract

Objective

To establish and validate a traditional Chinese medicine （TCM） clinical prediction model for polycystic ovary syndrome （PCOS） with metabolic syndrome （MetS） using a retrospective cohort study method， thereby facilitating the early prevention and intervention of PCOS.

Methods

Clinical data from PCOS patients were collected and divided into training and validation sets according to the time of visit. The patients in each set were further classified into MetS and non-MetS groups. The differences in TCM syndromes between the two groups were compared. Clinical data of patients were used as covariates， with MetS as the outcome variable， to construct a TCM clinical prediction model for PCOS with MetS. The performance of the model was evaluated using receiver operating characteristic （ROC） curves and calibration curves， with internal validation conducted using the Bootstrap method. External validation was performed using ROC curves， calibration curves， calibration slopes， and calibration distances.

Results

A total of 1，063 PCOS patients were included， with a MetS prevalence rate of 27.66%. Lasso regression identified six TCM factors： hot flashes and night sweats， obesity， kidney deficiency and liver stagnation syndrome， phlegm-stasis intermingling syndrome， white greasy tongue coating， and pale red tongue. These were used to construct the prediction model for PCOS with MetS. The ROC curve C-statistic was 0.843 ［95%

（0.814–0.871）］， and the Youden index was 0.513， with a sensitivity of 82.3% and specificity of 69.0%. The Brier score from the calibration curve was 0.139. The internal validation using the Bootstrap method yielded a C-statistic of 0.838 and a Brier score of 0.142. The external validation ROC curve C-statistic was 0.824［95%

（0.774–0.874）］， and the Brier score is 0.149.

Conclusions

PCOS patients with phlegm-stasis intermingling syndrome have a higher risk of MetS， which is significantly discriminative for evaluating PCOS. This TCM clinical prediction model demonstrates high reliability and has valuable clinical application.

关键词

Keywords

references

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